The heavy weight of an eating disorder

Hiding and throwing away food, over-exercising, obsessing about weight. For Los Angeles acting student Evgenia Ermolenko, these habits marked the beginning of anorexia, which she has since been battling for almost seven years. “I started to care about the way I looked when I started taking acting classes in Moscow,” she says. “One of the teachers told me that I was not fat, but that for being an actress, that was not enough, because actors have to be perfect.”

From that moment as a 13-year-old, she tried to look perfect.

“I used to wake up in the middle of the night to weigh myself, and I knew it was not normal, but I could not stop myself; I wanted to make sure I was not gaining weight,” she says.

Ermolenko says she finds it difficult to describe her disorder.

“It is like I have two minds,” she says. “One mind makes you feel guilty about eating, but the other mind knows that it is not normal to feel this guilt.”

For many years, the “mind” that made Ermolenko feel guilty about eating was louder than her “rational mind,” making it impossible for her to eat normally.

“I am glad my mom noticed when she did; otherwise I don’t think I would have been able to recover,” Ermolenko says.

Like an estimated 24 million Americans, according to the National Eating Disorder Association, Ermolenko struggles with an eating disorder.

“Understanding Nutrition,” a nutrition textbook used at Santa Monica College, defines eating disorders as “eating behaviors that are neither normal nor healthy, including retrained eating, fasting, binge eating, and purging.”

Yvonne Ortega, a registered dietitian and nutrition professor at SMC, explains that not every eating disorder falls under the categories of anorexia, bulimia or binge eating.

“Disordered eating occurs when there is an obsessed preoccupation with food, calories and exercise that can be unhealthy,” Ortega says.

According to Ortega, there are different causes for eating disorders that include psychological disorders, sociocultural factors, and neurochemical conditions.

“We need to figure out the cause for each patient,” Ortega says. “For some, it might be issues going on in the family. For others, the cause can be the pressure they feel. Sometimes there are traumatic events that happened in childhood. I have worked with eating disorder patients that have been sexually abused, and it manifests in that way.”

Ortega says that the key to avoiding eating disorders is creating a healthy relationship with food.

“When people start to tie emotions with food is usually when we start to see eating disorders develop—for example, the guilt that people experience because they had a food that may be high in fat or sugar,” Ortega says.

Ortega explains that in order to prevent emotional ties with food, people should avoid using labels like “healthy food” or “junk food.”

“From an educator’s perspective, I really try not to give negative labels to food because I think that brings feelings of guilt, especially in kids,” Ortega says. “I try to teach along the philosophy that there is no bad food or good food; it is about reducing quantities and not eliminating a type of food.”

Ermolenko is still fighting to develop a healthy relationship with food.

“I try not to read the labels; my doctor says I should not do it, but I always buy the light version of everything,” Ermolenko says. “I also try not to compare myself to others, but is difficult. It was a problem for me growing up.”

Ortega claims that the key for people like Ermolenko who experience anxiety around food is to listen to body signals.

“The body will tell you when you are hungry and when you are full,” Ortega says. “I use what is called the hunger scale, and I try to get people to get back in touch with that. The scale ranges from one to 10, where 10 means being stuffed and one means being starving.”

For the dietitian, five is the ideal hunger level at which the body is comfortably satisfied.

“You never want to be a one or a 10,” Ortega says. “When it goes as low as three, it is time to intervene and have snack. When people ignore the symptoms of hunger and deny food to their bodies and reach the point where they are hurting the body, it’s time to look for help.”

The dietitian recommends that friends and family look for signs of an eating disorder.

“Physically we can see symptoms like hair loss, nails breaking constantly because the body is malnourished, and bad skin,” Ortega says.

Ortega explains that weight loss is not always indicative of an eating disorder.

“People with bulimia seem to be of a normal weight, so that might not be an indicator for friends and family, but there are other signs they might look for—the individual may be using laxatives or medications to lose weight, or they may also notice if the person goes to the bathroom after eating,” Ortega says.

According to Ortega, there are also social symptoms that may be telling.

“If someone is isolating and avoiding social situations, usually something is wrong,” she says.

The dietitian emphasizes the need to recognize symptoms and seek help.

Diego Morales has worked as a nurse at center for eating disorders for three years. He says that the most difficult part of his job is dealing with patients who do not want help.

“They know they have a problem, but they refuse the help; they lie to the counselors and to themselves,” Morales says.

The nurse claims that eating disorders have the highest fatality rate of any psychiatric disorder.

In California, insurers must pay for residential treatment “for eating disorders and other serious mental illnesses under the state’s mental health parity law,” according to the U.S. Court of Appeals for the Ninth Circuit. However, the National Eating Disorders Association states that insurance companies often refuse coverage for residential treatment of eating disorders and other mental conditions, which can cost more than $1,000 daily.

According to Ortega, education can help reduce the ocurrences of eating disorders.

“I really emphasize the importance of mindful eating in my nutrition classes here at SMC, and the fact that we eat for the purpose of nourishment,” she says. “We have associated food with so much more than nourishment, we get to the point where people are no longer listening to their bodies.”

Ortega reminds students who are dealing with stress that food should not be used as an escape.

“Food is usually the place students go to when they are stressed out, but they need to find healthier ways to deal with stress, anxiety or depression,” Ortega says. “Understand that food is only fuel for our body, and avoid the emotional connections with food because they might lead to eating disorders.”

For Ermolenko, it is still a daily struggle to overcome the guilt she sometimes feels when she eats.

“I know I am not cured, but I have learned to live and ignore the other part of my mind that makes me feel guilty when I eat,” she says.